Mental health issues and workplace violence in healthcare 1.

Mental health issues and workplace violence in healthcare

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Mental health issues and workplace violence in healthcare 2.

Abstract

The purpose of this systematic integrative essay is to examine the challenges and

barriers encountered in mental healthcare systems, as well as the impact they have on families.

The databases Web of Science, Scopus, Medline, and Cochrane were searched using terms

related to mental health, family care, and healthcare systems. I included and critically evaluated

studies published in English between 2019 and 2023 that directly or indirectly examined public

mental health policies and their effects on families. I used an inductive content analysis approach

to analyze my findings. A total of 32 articles were identified as meeting quality indicators. Many

structural, cultural, economic, and healthcare barriers contribute to the mental health treatment

gap. The family covers the deficiencies and weaknesses of the care systems, resulting in carer

overload and a decline in quality of life. It is recognized that people with mental illnesses and

their families should be able to participate in policy development and thus contribute to the

global strengthening of mental healthcare systems.

Mental health issues and workplace violence in healthcare 3.

Introduction

More than half of the world's population is currently employed, and 15% of working-age

adults have a mental disorder. Without effective support, mental disorders and other mental

health conditions can affect a person's confidence and identity at work, capacity to work

productively, absences, and ease of retaining or gaining work. Every year, depression and

anxiety account for 12 billion lost working days. Furthermore, even though work is important for

recovery, people with severe mental health conditions are largely excluded from it. Mental health

issues can have an impact on families, carers, colleagues, communities, and society as a whole.

Every year, depression and anxiety cost the global economy one trillion dollars in lost

productivity.

Overall, this research paper focuses on Behavioural Health Associates and the challenges

they face as healthcare employees when dealing with a mentally ill patient, visitor, or colleague.

The paper will look into the causes, consequences, and prevention and management strategies,

with the ultimate goal of promoting a safe and healthy workplace.

Mental health issues and workplace violence in healthcare 4.

Mental health issues and workplace violence in healthcare

Violence in the workplace in healthcare settings

Although workplace violence affects almost all industries and worker groups, it is clear

that violence in healthcare settings poses a significant risk to public health and is a growing

occupational health concern. The healthcare and social service industries have the highest rates

of workplace violence injuries, with workers in these industries five times more likely than other

workers to be injured (Dadfar & Lester, 2021). Workplace violence hurts the physical and

emotional well-being of all parties involved. According to Dadfar and Lester (2021), workplace

violence can lead to increased job stress, anxiety, PTSD, job dissatisfaction, occupational

burnout, and absenteeism. It also has an impact on patient outcomes and safety because it can

lead to clinical and therapeutic errors as well as disrupt the nurse-client therapeutic relationship.

As a result, all stakeholders must work together to create a healthy and safe workplace that has

zero tolerance for violence (Workplace Violence Toolkit: Policies & Resources – Workplace

Violence Prevention Policies, 2023).

Workplace violence is becoming increasingly prevalent in the healthcare industry.

According to statistics, the severity and frequency of workplace violence in healthcare settings

are on the rise (Dadfar & Lester, 2021). Workplace violence has an impact on both the physical

and emotional well-being of all parties involved. Workplace violence, according to Dadfar and

Lester (2021), can increase job stress, anxiety, PTSD, job dissatisfaction, occupational burnout,

and absenteeism. It also has an impact on patient outcomes and safety because it can lead to
Mental health issues and workplace violence in healthcare 5.

clinical and therapeutic errors as well as a breakdown in the nurse-client therapeutic relationship.

As a result, all stakeholders must work together to create a healthy and safe workplace that has

no tolerance for violence.

Contributing Factors

The causes of workplace violence are complex and can be difficult to pinpoint. However,

some common contributing factors include job stress, personal stress, alcohol and substance

abuse, and conflicts with coworkers or supervisors. Workplace violence can be exacerbated in

some cases by environmental factors such as layoffs, financial difficulties, and community

violence (Pagnucci et al., 2022). According to the College of Nurses of Ontario Practise

Guideline: Conflict Prevention and Management guideline, the client's mental or physical state is

a significant contributing factor to nurse-client conflict (Conflict Prevention and Management -

Practise Guideline (CNO) | Long-Term Care Best Practises Toolkit, 2nd Edition, 2018). Patients

who are intoxicated, tired, anxious, or have a history of aggressive behavior, for example, are

more likely to be violent.

The PRN can also contribute to the escalation of workplace violence through

communication. A nurse, for example, who does not communicate effectively with the patient

may aggravate the patient and increase the risk of conflict. In other cases, nurses who judge,

label, or misunderstand a patient may escalate workplace violence. Other communication errors

that may contribute to workplace violence include the use of threatening tone, gestures, or body

language (Wirth et al., 2021). Nurses who lack cultural competency may have incorrect

perceptions of cultural differences or fail to identify language barriers, contributing to conflict.

Mental health issues and workplace violence in healthcare 6.

Furthermore, the PRN can contribute to workplace violence if they do not listen to the concerns

of the family or do not provide adequate health information.

Prevention of Workplace Violence

To address workplace violence in various sectors of healthcare organizations, a

multidimensional and multidisciplinary approach is necessary. To help detect and reduce the

causes of violence, healthcare organizations must collaborate with law enforcement. Existing

workplace policies and guidelines should be reviewed and updated. Healthcare organizations'

leaders must develop a process for reporting incidents of workplace violence and assault. As part

of the safety and health initiative, hospitals must follow OSHA's guidelines for preventing

workplace violence for health and social service workers.

The program should include leadership commitment, employee involvement, hazard

prevention, and program evaluation. Medical and psychological counseling initiatives for

workers who have been abused should be included in the program. Policies that enable reporting,

recording, and monitoring of occurrences will be beneficial. Different healthcare departments

have different incident rates, necessitating different intervention strategies.

The Emergency Nurses Association must take the lead in advocating for legislative

penalties for violent perpetrators. Nevada, Colorado, Delaware, Arizona, Indiana, Kentucky,

South Carolina, Rhode Island, Vermont, Virginia, Washington, Wisconsin, Arkansas, and

Illinois are among the 30 states that have legalized criminal penalties for violent offenders.

Educating employees and supporting victims of workplace violence effectively reduces violent

occurrences. Organizations must enforce and implement policies and procedures that reduce the
Mental health issues and workplace violence in healthcare 7.

prevalence of violence (National Nurses United, 2020). Healthcare organizations must educate

their staff on how to detect the possibility of violence and how to use intensification methods and

methods of requesting assistance to prevent or respond to ferocity.

Barriers and facilitators to effective conflict de-escalation

Violent and aggressive incidents are common in mental health settings and are frequently

managed with high-risk physical interventions such as restraint and seclusion. De-escalation is a

first-line technique for managing conflict behaviors and preventing violence and aggression.

There has been little research into the use of de-escalation in high-security settings (Godman et

al., 2020). This study looked into the barriers and facilitators of using de-escalation for conflict

behaviors from the perspectives of staff, patients, and carers.

De-escalation aims to reduce violence and aggression, and thus avoid the use of

restrictive interventions, by negotiating a mutually agreeable solution to the aggressor's concerns.

Non-provocative communication skills are used to gradually resolve potentially aggressive

situations by redirecting the patient to a calmer personal space. A systematic review found

significant heterogeneity in the content and duration of de-escalation training courses, as well as

a lack of clarity regarding training effectiveness (Godman et al., 2020).

Benefits

i. Improved Quality Through Specialised Expertise

"Mental illness and substance use disorders - often referred to as behavioral health

problems - are associated with high healthcare utilization and medical spending, especially when
Mental health issues and workplace violence in healthcare 8.

co-occurring with physical health problems," according to a National Centre for Biotechnology

Information (NCBI) study (Cheney, 2021).

Hospitals are focusing on improving access to high-quality behavioral health services and

resources to reduce the use of unnecessary resources and medical spending. The right partner

will have access to exemplary resources, best practices, and national trends, allowing a hospital

to better integrate behavioral health services while providing the highest level of treatment at the

lowest cost (Cheney, 2021). Furthermore, having a behavioral health unit or hospital allows

patients to be transferred to the appropriate care setting more quickly.

ii. Reduced Patient and Staff Risk

Treating behavioral health patients carries an inherent risk due to the nature of the

conditions treated. Having proper behavioral health resources and training to successfully help

patients recover can benefit the entire hospital, whether it's through reducing the risk of self-

harm for a patient in the behavioral health unit or quickly identifying disorders such as

depression or anxiety in a patient receiving care in another setting (Cheney, 2021). This not only

reduces risk during treatment but also reduces the possibility of rehospitalization because health

needs are addressed in the same care episode.

iii. Increased Capability to Serve the Community

While the clinical and operational benefits of collaboration are significant, the most

significant benefit of collaboration is the impact it can have on the community. Collaboration

with a behavioral health expert enables a hospital to meet the unique needs of the community it

serves in a high-quality, cost-effective manner (Cheney, 2021). This is especially important

Mental health issues and workplace violence in healthcare 9.

given that 21 percent of American adults, or 52.9 million people, suffer from mental illness each

year (Cheney, 2021).

Learning Reflection

Before beginning my research on workplace violence and mental health issues, I was

aware that it was a serious issue affecting nurses worldwide. However, my research has taught

me the critical role that healthcare systems and leaders play in preventing workplace violence

and assisting victims. However, I need to learn more about my behavior and values, as well as

how they contribute to workplace violence. I now understand the significance of creating a safe

and supportive work environment, as well as the various steps that can be taken to accomplish

this. I will also make certain that I am well-versed in the policies and procedures in place to

prevent workplace violence and assist victims.

Conclusion

Finally, workplace violence is a complex and growing concern in the healthcare industry,

particularly for both patients and workers. Workplace violence can cause physical injuries,

emotional distress, psychological trauma, decreased job satisfaction, decreased productivity, and

increased nurse turnover. To prevent and manage workplace violence, experts must employ

communication strategies such as active listening and appropriate body language. Employers

should provide their employees with training, resources, and assistance. By promoting a safe and

healthy work environment, the quality of mental health care patients and their safety can be

improved, while also protecting the well-being of healthcare workers.

Mental health issues and workplace violence in healthcare 10.

References

Cheney, C. (2021). Tackling the top 3 challenges in Behavioral Health. HealthLeaders

Media. Retrieved January 11, 2022, from

https://www.healthleadersmedia.com/clinical-care/tackling-top- 3-challenges-behavioral-health.

Dadfar, M., & Lester, D. (2021). Workplace violence (WPV) in healthcare

systems. Nursing Open, 8(2), 527–528. https://doi.org/10.1002/nop2.713

Pagnucci, N., Ottonello, G., Capponi, D., Catania, G., Zanini, M., Aleo, G., Timmins, F.,

Sasso, L., & Bagnasco, A. (2022). Predictors of events of violence or aggression against nurses

in the workplace: A scoping review. Journal of Nursing Management, 30(6), 1724–1749.

https://doi.org/10.1111/jonm.13635

Wirth, T., Peters, C., Nienhaus, A., & Schablon, A. (2021). Interventions for Workplace

Violence Prevention in Emergency Departments: A Systematic Review. International Journal of

Environmental Research and Public Health, 18(16), 8459.

https://doi.org/10.3390/ijerph18168459

Goodman, H., Papastavrou Brooks, C., Price, O., & Barley, E. A. (2020). Barriers and

facilitators to the effective de-escalation of conflict behaviors in forensic high-secure settings: a

qualitative study. International journal of mental health systems, 14(1), 1-16.

College of Nurses of Ontario. (2019, April). Entry-to-Practice Competencies for Ontario

Registered Practical Nurses. https://www.cno.org/globalassets/docs/reg/41042_entrypracrpn-

2020.pdf
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Conflict Prevention and Management—Practice Guideline (CNO) | Long-Term Care

Best Practices Toolkit, 2nd edition. (n.d.). Retrieved February 14, 2023, from

https://ltctoolkit.rnao.ca/node/949

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Workplace Violence Toolkit: Policies & Resources – Workplace Violence Prevention

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https://nursesunions.ca/workplace-violence-toolkit-policies-resources-workplace-violence-

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